Short-Course Treatment Regimen of Indian Visceral Leishmaniasis with an Indian Liposomal Amphotericin B Preparation (Fungisome™)
India bears the burden of about half of global visceral leishmaniasis (VL) cases with emerging problems of stibanate resistance. Liposomal preparations have improved treatment outcome through shorter duration of therapy and lower toxicity compared with conventional amphotericin B. We report the effi...
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Veröffentlicht in: | The American journal of tropical medicine and hygiene 2016-01, Vol.94 (1), p.93-98 |
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creator | Goswami, Rama P Goswami, Rudra P Das, Sukhen Satpati, Aditya Rahman, Mehebubar |
description | India bears the burden of about half of global visceral leishmaniasis (VL) cases with emerging problems of stibanate resistance. Liposomal preparations have improved treatment outcome through shorter duration of therapy and lower toxicity compared with conventional amphotericin B. We report the efficacy of two short-course regimens of an Indian preparation of liposomal amphotericin B (Fungisome™) for VL caused by Leishmania donovani in India. An open-label, randomized, single-center comparative study was undertaken from 2008 to 2011, involving 120 treatment naive non-human immunodeficiency virus VL patients randomly allocated to two groups. Fungisome™ was given, in groups A (N = 60), 5 mg/kg daily for 2 days and B (N = 60), 7.5 mg/kg daily for 2 days, as intravenous infusion. Initial cure rate was 100% in both the groups after 1 month posttreatment. At 6 months after completion of treatment, definitive cure rate was group A 90% (54/60, 95% confidence interval (CI): 80.55-95.72%); group B: 100% (95% CI: 95.92-100%); (P = 0.027). No serious adverse events occurred in either group. The short-course, 2-day regimen of 15 mg/kg Fungisome™ infusion is easy to administer, effective, and safe for treatment of VL caused by L. donovani in India. |
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Liposomal preparations have improved treatment outcome through shorter duration of therapy and lower toxicity compared with conventional amphotericin B. We report the efficacy of two short-course regimens of an Indian preparation of liposomal amphotericin B (Fungisome™) for VL caused by Leishmania donovani in India. An open-label, randomized, single-center comparative study was undertaken from 2008 to 2011, involving 120 treatment naive non-human immunodeficiency virus VL patients randomly allocated to two groups. Fungisome™ was given, in groups A (N = 60), 5 mg/kg daily for 2 days and B (N = 60), 7.5 mg/kg daily for 2 days, as intravenous infusion. Initial cure rate was 100% in both the groups after 1 month posttreatment. At 6 months after completion of treatment, definitive cure rate was group A 90% (54/60, 95% confidence interval (CI): 80.55-95.72%); group B: 100% (95% CI: 95.92-100%); (P = 0.027). No serious adverse events occurred in either group. The short-course, 2-day regimen of 15 mg/kg Fungisome™ infusion is easy to administer, effective, and safe for treatment of VL caused by L. donovani in India.</description><identifier>ISSN: 0002-9637</identifier><identifier>EISSN: 1476-1645</identifier><identifier>DOI: 10.4269/ajtmh.14-0657</identifier><identifier>PMID: 26526926</identifier><language>eng</language><publisher>United States: The American Society of Tropical Medicine and Hygiene</publisher><subject>Adolescent ; Adult ; Amphotericin B - administration & dosage ; Amphotericin B - therapeutic use ; Antiprotozoal Agents - administration & dosage ; Antiprotozoal Agents - therapeutic use ; Child ; Child, Preschool ; Drug Administration Schedule ; Female ; Humans ; India - epidemiology ; Leishmania donovani ; Leishmaniasis, Visceral - drug therapy ; Leishmaniasis, Visceral - epidemiology ; Male ; Young Adult</subject><ispartof>The American journal of tropical medicine and hygiene, 2016-01, Vol.94 (1), p.93-98</ispartof><rights>The American Society of Tropical Medicine and Hygiene.</rights><rights>The American Society of Tropical Medicine and Hygiene 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-5b91df9bce8f74e88386336d6c82652c8525b2e17cbf4b6a1c884a285a4746e03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710453/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710453/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26526926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goswami, Rama P</creatorcontrib><creatorcontrib>Goswami, Rudra P</creatorcontrib><creatorcontrib>Das, Sukhen</creatorcontrib><creatorcontrib>Satpati, Aditya</creatorcontrib><creatorcontrib>Rahman, Mehebubar</creatorcontrib><title>Short-Course Treatment Regimen of Indian Visceral Leishmaniasis with an Indian Liposomal Amphotericin B Preparation (Fungisome™)</title><title>The American journal of tropical medicine and hygiene</title><addtitle>Am J Trop Med Hyg</addtitle><description>India bears the burden of about half of global visceral leishmaniasis (VL) cases with emerging problems of stibanate resistance. Liposomal preparations have improved treatment outcome through shorter duration of therapy and lower toxicity compared with conventional amphotericin B. We report the efficacy of two short-course regimens of an Indian preparation of liposomal amphotericin B (Fungisome™) for VL caused by Leishmania donovani in India. An open-label, randomized, single-center comparative study was undertaken from 2008 to 2011, involving 120 treatment naive non-human immunodeficiency virus VL patients randomly allocated to two groups. Fungisome™ was given, in groups A (N = 60), 5 mg/kg daily for 2 days and B (N = 60), 7.5 mg/kg daily for 2 days, as intravenous infusion. Initial cure rate was 100% in both the groups after 1 month posttreatment. At 6 months after completion of treatment, definitive cure rate was group A 90% (54/60, 95% confidence interval (CI): 80.55-95.72%); group B: 100% (95% CI: 95.92-100%); (P = 0.027). No serious adverse events occurred in either group. The short-course, 2-day regimen of 15 mg/kg Fungisome™ infusion is easy to administer, effective, and safe for treatment of VL caused by L. donovani in India.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Amphotericin B - administration & dosage</subject><subject>Amphotericin B - therapeutic use</subject><subject>Antiprotozoal Agents - administration & dosage</subject><subject>Antiprotozoal Agents - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Leishmania donovani</subject><subject>Leishmaniasis, Visceral - drug therapy</subject><subject>Leishmaniasis, Visceral - epidemiology</subject><subject>Male</subject><subject>Young Adult</subject><issn>0002-9637</issn><issn>1476-1645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQxi0EokvhyBX5WA4ptuN_uSCVVQuVVgJB4Wo53snG1cYOdgLqFfEkPBpPgkOXCm6cZqT5zaf55kPoKSWnnMnmhb2ehv6U8opIoe6hFeVKVlRycR-tCCGsamStjtCjnK8JoZpR-hAdMSnKLpMr9O1DH9NUreOcMuCrBHYaIEz4Pex8aXDs8GXYehvwJ58dJLvHG_C5H2zwNvuMv_qpx2V8oDZ-jDkOBTsbxj5OkLzzAb_C7xKMNtnJx4BPLuaw8wWDn99_PH-MHnR2n-HJoR6jjxfnV-s31ebt68v12aZynJGpEm1Dt13TOtCd4qB1rWVdy610erHjtGCiZUCVazveSkud1twyLSxXXAKpj9HLW91xbgfYumKz2DFj8oNNNyZab_6dBN-bXfxiuKKEi7oInBwEUvw8Q57MsPxkv7cB4pwNVVI0WijF_wcluuGcLGh1i7oUc07Q3V1EiVkiNr8jNpSbJeLCP_vbxh39J9P6FwwIpgc</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Goswami, Rama P</creator><creator>Goswami, Rudra P</creator><creator>Das, Sukhen</creator><creator>Satpati, Aditya</creator><creator>Rahman, Mehebubar</creator><general>The American Society of Tropical Medicine and Hygiene</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>M7N</scope><scope>5PM</scope></search><sort><creationdate>20160101</creationdate><title>Short-Course Treatment Regimen of Indian Visceral Leishmaniasis with an Indian Liposomal Amphotericin B Preparation (Fungisome™)</title><author>Goswami, Rama P ; 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Liposomal preparations have improved treatment outcome through shorter duration of therapy and lower toxicity compared with conventional amphotericin B. We report the efficacy of two short-course regimens of an Indian preparation of liposomal amphotericin B (Fungisome™) for VL caused by Leishmania donovani in India. An open-label, randomized, single-center comparative study was undertaken from 2008 to 2011, involving 120 treatment naive non-human immunodeficiency virus VL patients randomly allocated to two groups. Fungisome™ was given, in groups A (N = 60), 5 mg/kg daily for 2 days and B (N = 60), 7.5 mg/kg daily for 2 days, as intravenous infusion. Initial cure rate was 100% in both the groups after 1 month posttreatment. At 6 months after completion of treatment, definitive cure rate was group A 90% (54/60, 95% confidence interval (CI): 80.55-95.72%); group B: 100% (95% CI: 95.92-100%); (P = 0.027). No serious adverse events occurred in either group. 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subjects | Adolescent Adult Amphotericin B - administration & dosage Amphotericin B - therapeutic use Antiprotozoal Agents - administration & dosage Antiprotozoal Agents - therapeutic use Child Child, Preschool Drug Administration Schedule Female Humans India - epidemiology Leishmania donovani Leishmaniasis, Visceral - drug therapy Leishmaniasis, Visceral - epidemiology Male Young Adult |
title | Short-Course Treatment Regimen of Indian Visceral Leishmaniasis with an Indian Liposomal Amphotericin B Preparation (Fungisome™) |
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